Cetuximab (Erbitux)

Find out what cetuximab is, how you have it and other important information about taking cetuximab.

Cetuximab is a cancer treatment drug and is also known by its brand name Erbitux.

It is a treatment for:

advanced bowel cancer

head and neck cancer

How it works

Some cancer cells have receptors called epidermal growth factor receptors (EGFR) on their surface. A protein produced naturally in the body called epidermal growth factor (EGF) attaches to the receptors. This triggers the cell to grow and divide into more cells. Cetuximab works by attaching itself to the EGF receptors. This blocks the EGF protein from reaching the cancer cells and stops them from growing.

Studies have shown that cetuximab doesn't work in people whose bowel cancer cells have a genetic change called a k-ras mutation. Around 4 out of 10 people (40%) with bowel cancer have a k-ras mutation. So doctors will test your tumour sample to see if you have a normal k-ras gene before starting treatment.

How you have cetuximab

You have cetuximab as a drip into your bloodstream.

Into your bloodstream

You have the treatment through a drip into your arm. A nurse puts a small tube (a cannula) into one of your veins and connects the drip to it.

You might need a central line. This is a long plastic tube that gives the drugs into a large vein, either in your chest or through a vein in your arm. It stays in while you’re having treatment, which may be for a few months.

When you have it

The first cetuximab drip will take 2 hours. If there are no problems, the following treatments take 1 hour.

You usually have a cetuximab drip once a week. It is often given with chemotherapy.

Cetuximab is given an hour before chemotherapy.

If you are having radiotherapy, you usually have the first cetuximab treatment 1 week before radiotherapy.

Tests during treatment

You have blood tests before starting treatment and during your treatment. They check your levels of blood cells and other substances in the blood. They also check how well your liver and kidneys are working.

Side effects

Important information

Blood clots

You are more at risk of developing a blood clot during treatment. Drink plenty of fluids and keep moving to help prevent clots.

Treatment for other conditions

Always tell other doctors, nurses, pharmacists or dentists that you’re having this treatment if you need treatment for anything else, including teeth problems.

Immunisations

Don’t have immunisations with live vaccines while you’re having treatment and for at least 6 months afterwards.

In the UK, live vaccines include rubella, mumps, measles, BCG, yellow fever and shingles vaccine (Zostavax).

You can:

have other vaccines, but they might not give you as much protection as usual

have the flu vaccine (as an injection)

be in contact with other people who've had live vaccines as injections

Avoid close contact with people who’ve recently had live vaccines taken by mouth (oral vaccines) such as oral polio or the typhoid vaccine.

This also includes the rotavirus vaccine given to babies. The virus is in the baby’s poo for up to 2 weeks and could make you ill. So, avoid changing their nappies for 2 weeks after their vaccination if possible. Or wear disposable gloves and wash your hands well afterwards.

You should also avoid close contact with children who have had the flu vaccine nasal spray if your immune system is severely weakened.

Breastfeeding

Don't breastfeed during this treatment or for 2 months after the last dose because the drug may come through in the breast milk.

Pregnancy and contraception

This treatment might harm a baby developing in the womb. It is important not to become pregnant or father a child while you are having treatment and for a few months afterwards. Talk to your doctor or nurse about effective contraception before starting treatment.

Other medicines

Cancer drugs can interact with some other medicines and herbal products. Tell your doctor or pharmacist about any medicines you are taking. This includes vitamins, herbal supplements and over the counter remedies.

More information about this treatment

For further information about this treatment go to the electronic Medicines Compendium (eMC) website.

Cancer research information

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